Respiratory Outcomes After 6 Months of Hospital Discharge in Patients Affected by COVID-19: A Prospective Cohort.

Gabriele Da Silveira Prestes,Cristiane Ritter,Roger Walz,Felipe Dal-Pizzol,Carla Sasso Simon

doi:10.3389/fmed.2022.795074

Abstract

BackgroundConsidering millions of people affected by Coronavirus disease 2019 (COVID-19), long-lasting sequelae can significantly impact health worldwide. Data from prospective studies in lower-middle-income countries on persistent lung dysfunction secondary to COVID-19 are lacking. This work aims to determine risk factors and the impact of persistent lung dysfunctions in COVID-19 survivors.MethodsObservational and prospective cohort of patients admitted to a tertiary hospital from June 2020 to November 2020. Persistence of chest CT scan alterations, desaturation in the six-minute walk test (6MWT), forced expiratory volume in one second (FEV1), lung carbon monoxide diffusion (DLCO), and maximum inspiratory pressure (MIP) were measured 6 months after hospital discharge. Additionally, the Barthel index (BI) and the Modified Medical Research Council (mMRC) Dyspnea Scale were used to determine the impact of lung dysfunction in activities of daily living (ADL).ResultsIt was included 44 patients. Sixty percent had persistent lung CT scan abnormalities. From 18 to 43% of patients had at least one pulmonary function dysfunction, a decrease in FEV1 was the least prevalent (18%), and a reduction in DLCO and MIP was the most frequent (43%). In general, female gender, comorbidity index, and age were associated with worse lung function. Additionally, the presence of lung dysfunction could predict worse BI (r-square 0.28) and mMRC (r-square 0.32).ConclusionLong-term lung dysfunction is relatively common in survivors from severe COVID-19 and impacts negatively on ADL and the intensity of dyspnea, similar to studies in high-income countries.

Highlights

In addition to the characteristic symptoms of the acute infectious process of coronavirus disease 2019 (COVID-19), such as fever, cough, and chest discomfort and, in severe cases, dyspnea and bilateral pulmonary infiltration [1, 2]; “post-COVID condition” reports are increasing
The study sample consisted of all consecutive patients admitted to the COVID-19 ward or intensive care unit (ICU) of a tertiary hospital from June 2020 to November 2020
Due to the importance of a timely description of lung abnormalities, we evaluated only the

Summary

Introduction

In addition to the characteristic symptoms of the acute infectious process of coronavirus disease 2019 (COVID-19), such as fever, cough, and chest discomfort and, in severe cases, dyspnea and bilateral pulmonary infiltration [1, 2]; “post-COVID condition” reports are increasing. The most common symptoms were fatigue, cognitive problems, and new-onset dyspnea. In this context, McGroder et al [6] evaluated patients 4 months after hospitalization. Few studies suggested that this pattern persist up to 12 months after hospitalization [8–10]. Considering millions of people affected by Coronavirus disease 2019 (COVID-19), long-lasting sequelae can significantly impact health worldwide. This work aims to determine risk factors and the impact of persistent lung dysfunctions in COVID-19 survivors

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